1. Disaster Planning and Organization Dr. Eric Goedecke Asst. Professor of Emergency Medicine

2. Learning Objectives Steps of disaster planning Concepts in management planning and interventions Quetzaltenango, Guatemala, Noviembre 2009. 2

3. Steps of Disaster Planning Planning Resource assessment Risk and hazard analysis Quetzaltenango, Guatemala, Noviembre 2009. 3

4. Risk and Hazard Analysis Assessment of threats to the locality – Geographic – Building – Population cluster Children groups – Day care or schools – Summer camps – Field trips Quetzaltenango, Guatemala, Noviembre 2009. 4

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6. Risk and Hazard Analysis Environmental Hazards Weather – Tornados – Hurricanes Geographic – Earthquakes – Flood plains Quetzaltenango, Guatemala, Noviembre 2009. 6

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9. Risk and Hazard Analysis Man-made Hazards Chemicals – Production, storage and transport Biologic hazards Terrorism Transportation Hazards Materials Mass transit centers Quetzaltenango, Guatemala, Noviembre 2009. 9

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11. Resource Assessment Local resources – EMS – Police – Fire department – Cruz Rojas Volunteers – Rotary Club Children’s advocacy groups Quetzaltenango, Guatemala, Noviembre 2009. 11

12. Resource Assessment National – Cruz Rojas – FEMA – DMAT – National Police Agencies and unions – College of Physicians and Surgeons – Nurses Quetzaltenango, Guatemala, Noviembre 2009. 12

13. www.fema.gov/areyouready Quetzaltenango, Guatemala, Noviembre 2009. 13

14. Resource Needs Personnel – Pediatric specialists (if available) Equipment Supplies: water, food, blankets Shelter Suppliers with contact source – Back-up suppliers and contact sources Quetzaltenango, Guatemala, Noviembre 2009. 14

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16. Resource Needs Communications – Equipment and personnel – Telephone company/cell phones often overload – Ham radio / alternative methods Quetzaltenango, Guatemala, Noviembre 2009. 16

17. Resource Needs Transportation – Roads – Vehicles, public and private Maintaining access for emergency vehicles often problematic Quetzaltenango, Guatemala, Noviembre 2009. 17

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21. Planning is a Dynamic Process Plan before, during and after Contingency planning Continued revising Quetzaltenango, Guatemala, Noviembre 2009. 21

22. Plan Ahead Resource assessment – Be realistic about resources not already committed to the disaster – Know local limits When and how to call for outside resources – Scale of response Quetzaltenango, Guatemala, Noviembre 2009. 22

23. Plan Ahead Discuss with groups / individuals – Identify problems – Find options – Keep updated on response abilities Resources and personnel Vary by incident Quetzaltenango, Guatemala, Noviembre 2009. 23

24. Plan Ahead Involve all potential participants – Don’t overlook potential resources – Avoid improper assumptions Regular planning meetings – Risks of area – Unforeseen events Quetzaltenango, Guatemala, Noviembre 2009. 24

25. Planning Exercises Look for deficiencies Single components vs. multi-group – Moulage useful but complex – Inter-group cooperation Quetzaltenango, Guatemala, Noviembre 2009. 25

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27. Planning after Exercise Debriefing after exercise – Share information – Improve plan – Ensure dissemination of changes to plans Honest not defensive feedback from all Quetzaltenango, Guatemala, Noviembre 2009. 27

28. During the Disaster Constant revision of plan – New risks and resources – Loss of resources Flexibility – Alternate uses of resources – Alternate ways of transporting patient to resources or resources to patient Quetzaltenango, Guatemala, Noviembre 2009. 28

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31. Incident Command System IncidentCommander Planning CommandStaff Finance LogisticsOperations Quetzaltenango, Guatemala, Noviembre 2009. 31

32. Incident Command System Identified central commander with limited scope of control – leave chain of command for smaller groups intact Unified command Modular system Expand as needed Quetzaltenango, Guatemala, Noviembre 2009. 32

33. Medical control - Decisions Disaster interventions differ from everyday – less information – more victims – different priorities Stress for responders “Greatest good to greatest number” – may not be optimal care for each person Triage/treatment protocols for children will help providers Quetzaltenango, Guatemala, Noviembre 2009. 33

34. Documentation Need to provide permanent record Transfer of information from field to base hospital Limit information – will lose some details Quetzaltenango, Guatemala, Noviembre 2009. 34

35. Documentation problems Data loss / inaccuracies Patient limitations - unable to obtain / convey accurate information Multicopy permanent record Deterioration of record Identifying the nameless victim Quetzaltenango, Guatemala, Noviembre 2009. 35

36. Documentation uses To track patient movements To reunite families Epidemiological studies Evaluation and post disaster critique Long term sequelae and resupply Quetzaltenango, Guatemala, Noviembre 2009. 36

37. Conclusion Planning – risk / hazard analysis – resource assessment – planning is a dynamic process Incident Command System Quetzaltenango, Guatemala, Noviembre 2009. 37

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